How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | None | $165.96 | $177.83 | $177.83 |
BCBS Arkansas Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $363.08 | Professional | None | $275.42 | $302.00 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $257.04 | Facility | None | $173.78 | $173.78 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $173.78 | Professional | None | $100.00 | $128.82 | $173.78 |
United Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $380.19 | Facility | None | $186.21 | $323.59 | $380.19 |
United Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $229.09 | Professional | None | $117.49 | $158.49 | $229.09 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $35.48 | Professional | 53 · Discontinued | $33.88 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $16.60 | $17.78 | $17.78 |
Where Arkansas sits
The same service costs 4.0 times more in Hawaii than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Arkansas· 12th of 51
$275
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.